The latest legal showdown over the Affordable Care Act could make health insurance unaffordable for millions of Americans, some health policy experts say.

The latest legal showdown over the Affordable Care Act could make health insurance unaffordable for millions of Americans, some health policy experts say.

MONDAY, June 23, 2014 (HealthDay News) -- Women with breast cancer who test positive for gene mutations linked with breast and ovarian cancer are more likely than those without the mutations to choose more extensive surgery, a new study finds.

Genetic testing is recommended before surgery on breast cancer patients who are at higher risk of having mutations in the BRCA1 and BRCA2 genes. These mutations are associated with a substantial risk of developing breast and ovarian cancer in the future, according to the study authors.

"As soon as somebody hears they have a 65 percent chance of a new breast cancer in the future or an up to 60 percent chance of ovarian cancer, they are likely to do whatever they can to prevent that," lead author Dr. Elizabeth Lokich, an obstetrics and gynecology fellow at Brown University and at Women and Infants Hospital of Rhode Island, said in a university news release.

"Particularly because of what we found that it changes their surgical planning, it really makes the most sense to have this evaluation done preoperatively," she added.

The study involved 302 breast cancer patients in the United States. They underwent genetic testing prior to surgery, and 72 percent of those who tested positive for the BRCA1 and BRCA2 gene mutations eventually changed their surgery plans, typically deciding to have more extensive surgery such as removal of both breasts (double mastectomy) or removal of their ovaries.

All of the women in the study met National Comprehensive Cancer Network guidelines for genetic testing before making a decision about their surgery. Of the 302 women, 32 were found to have BRCA1 or BRCA2 gene mutations.

Among those who tested positive, 23 (72 percent) changed their surgical plans, compared with nearly 29 percent of those who tested negative.

Among those with the mutations, 31 percent chose lumpectomies -- a procedure that just removes the tumor and some surrounding tissue -- while 59 percent of women without the mutations chose this option. Nearly 60 percent of women with BRCA genes chose double mastectomy -- a procedure that removes both breasts -- compared to just 21 percent without BRCA genes. And, about 12 percent of women with the mutations chose ovary removal versus none of the women without the mutations.

The study, published online recently in the journal Gynecological Oncology, did not receive funding from makers of the genetic tests.

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